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Am Fam Physician. 2000;61(12):3543-3544

AAFP Urges White House to Oppose Pain Management Bill

In a May 22 letter to President Clinton, the American Academy of Family Physicians (AAFP) urged the White House to actively oppose H.R. 2260, the Pain Management Act of 1999. The legislation opposes physician-assisted suicide, which the AAFP also opposes. However, the bill, in its provisions to outlaw physician-assisted suicide, may inadvertently put physicians who are appropriately prescribing pain narcotics at risk for civil and criminal liability. The measure redirects the priorities of the Drug Enforcement Administration (DEA) by requiring DEA agents to determine whether the death of a patient on a high dose of medication was a physician-assisted suicide or the legitimate use of narcotics to relieve pain. In urging White House opposition, the AAFP asks for the president to object to including the pain management legislative language in any appropriations conference report as well as enactment of a separate bill.

Healthy People 2010 Available for Download

Healthy People 2010 Understanding and Improving Health, the new national health objectives released by the Department of Health and Human Services (DHHS), is available for download from the DHHS Web site at It includes 467 health objectives, organized into 28 focus areas. The material was developed over a four-year period through focus group consultation, public hearings and public comment periods. Further information regarding mail orders is available by calling 301-468-1273, ext. 243.

Columbia/HCA Agrees to Pay $745 Million to Settle Case

The nation's biggest hospital chain, Columbia/HCA Healthcare Corp., has tentatively agreed to pay the government $745 million to settle civil fraud charges. If approved, such a penalty would be the largest ever imposed on a health care company. The case arises from allegations that Columbia/HCA systematically defrauded Medicare. According to the Justice Department, Columbia/HCA was involved with “upcoding,” the practice of upgrading the seriousness of illnesses to receive larger Medicare payments; and adding unnecessary diagnostic analyses to routine blood tests. The settlement does not end the federal investigation of Columbia/HCA, and further liability could be found. Columbia/HCA operates 220 facilities in 22 states.

New Publication to Educate Voters on Health Issues

In an effort to help citizens make informed decisions about candidates in the upcoming elections, Kaiser Family Foundation and the League of Women Voters have published a guide on key health topics. “Join the Debate” covers issues such as health coverage for the uninsured, patients' rights under managed care, medicare reform, prescription drug coverage for seniors and long-term care. Copies of the guide (publication no. 1574) are available on the Kaiser Family Foundation's Web site ( or the League of Women Voters' Web site ( or by calling the Kaiser Family Foundation at 800-656-4533.

Nutrition Program to Focus on Home Care Education

The Nutrition Screening Initiative (NSI) will build on the success of its “Nutrition Care Alerts” by launching the alerts for home care. The original “Nutrition Care Alerts” were developed after the NSI board studied nutrition-related problems that were prevalent in residents of long-term care facilities. The new educational materials will be written for caregivers of elderly persons in the home. In addition, existing care alerts will be adapted for use in the home care setting. “Care Alerts for Home Care” will raise awareness of the same nutrition conditions addressed in the original version. It highlights warning signs and steps to take for unintended weight loss, dehydration, pressure ulcers and tube feeding complications. To order nutrition care materials, contact the NSI at P.O. Box 753, Waldorf, MD 20604-0753, send e-mail to or call 202-625-1662.

AAFP Urges Reauthorization of NHSC

In a statement drafted for a Senate subcommittee, the AAFP is calling for legislation to reauthorize the National Health Service Corps (NHSC) and make NHSC scholarships taxexempt. According to the statement, “the Bureau of Primary Care estimates that there is an unmet need for 20,000 primary medical, oral and mental health clinicians… At current levels, the corps is only equipped to meet 12 percent of the health care access needs in the nation's underserved areas.” The NHSC was created in 1970 to place primary care physicians and dentists in areas of greatest need—mainly in economically disadvantaged urban and rural areas. Even though the corps' authorization expires this year, a reauthorization bill has yet to be introduced in the House or the Senate.

Dental Group Warns of Oral Problems of Cancer Therapy

The Academy of General Dentistry Foundation is leading an initiative to educate health professionals and patients about the adverse effects of cancer treatments. Therapies such as radiation, chemotherapy and bone marrow transplantation have become more therapeutically successful, albeit more powerful, in the past 10 years. The mouth is a frequent site of side effects. In fact, according to foundation board member J. Gordon Wright, D.D.S., “oral complications are cited as the single most common cause of the interruption and premature termination of treatment regimens for cancer patients.” Complications include rampant tooth decay, salivary gland dysfunction and mouth sores. The group recommends that patients with cancer contact their dentist at the outset of cancer therapy and treat all preexisting oral conditions. For more information, visit the foundation's Web site (

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